Endocrine Abstracts

Introduction: Primary hyperparathyroidism is a common endocrinopathy associated with autonomous hypersecretion of PTH by one or more parathyroid glands. This work aims to study the epidemiological, clinical, biological, radiological, and therapeutic profile of primary hyperparathyroidism, as well as its preoperative complications.

Material and methods: A retrospective descriptive study of 50 patients followed at the Endocrinology-Diabetology-Nutrition Department of Mohammed-VI-University-Hospital-Center-Oujda-Morocco for primary hyperparathyroidism. Data were collected from medical records and analyzed using SPSS-V21 software.

Results: The mean age was 55.24±12.9 years, with a clear female predominance in 78% of cases, 79% of whom were menopausal. The circumstances of discovery were dominated by bone pain, recurrent renal lithiasis and abdominal pain, and were fortuitous in only 29% of cases. Biologically, hypercalcemia was found in 84% of cases, with a mean of 127±24 mg/l, and hypercalciuria in 74%. The mean PTH1-84biointact value was 408± 586 pg/ml and vitamin D deficiency was observed in 62% of patients. Cervical ultrasonography was carried out in all our patients, localizing the tumor in 88%, thoracic CT objective a medial ectopic parathyroid tumor in 2 cases, and SestaMIBI scintigraphy was performed in nine patients whose cervical ultrasonography failed to localize the parathyroid adenoma. Osteoporosis and renal lithiasis were the main preoperative complications, occurring in 34% and 32% of cases in our series respectively; there was a high prevalence of brown tumours in 18% of cases; 90% of patients underwent surgical treatment, 13% of them complicated by hypocalcemia. Anatomopathological findings were in favor of parathyroid adenoma in 88.6%, parathyroid hyperplasia in 5.8%, and parathyroid carcinoma in 2.9%.

Conclusions: Primary hyperparathyroidism is responsible for altered phosphocalcic metabolism and is a frequent cause of hypercalcemia. Etiologies are dominated by parathyroid adenoma, with a clear female predominance, and treatment is mainly surgical.